Healthcare Provider Details

I. General information

NPI: 1881381663
Provider Name (Legal Business Name): AMPLA HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/20/2023
Last Update Date: 04/20/2023
Certification Date: 04/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

680 COHASSET RD
CHICO CA
95926-2213
US

IV. Provider business mailing address

PO BOX AD
YUBA CITY CA
95992-1396
US

V. Phone/Fax

Practice location:
  • Phone: 530-342-4395
  • Fax: 530-894-2325
Mailing address:
  • Phone: 530-751-3778
  • Fax: 530-751-1237

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: VICKI L CHISSIE
Title or Position: PATIENT ACCOUNTS MANAGER
Credential:
Phone: 530-751-3778